TY - JOUR
T1 - Compartment Syndrome in Tibial Plateau Fractures
T2 - Do Previously Established Predictors Have External Validity?
AU - Marchand, Lucas S.
AU - Working, Zachary M.
AU - Rane, Ajinkya A.
AU - Elliott, Iain S.
AU - Gilbertson, Ellen
AU - Rothberg, David L.
AU - Higgins, Thomas F.
AU - Haller, Justin M.
N1 - Publisher Copyright:
© 2020 Lippincott Williams and Wilkins. All rights reserved.
PY - 2020/5/1
Y1 - 2020/5/1
N2 - Objective:To test previously established radiographic predictors of compartment syndrome in tibial plateau fractures and determine whether novel measurements may further improve a surgeon's ability to identity patients at high risk for developing this outcome.Design:Retrospective review.Setting:Academic Level I trauma center.Patients:Five hundred thirteen patients with tibial plateau fractures treated operatively over a 10-year period (OTA/AO 41B1-3 & 41C1-3; Schatzker I-VI).Intervention:Previously established plain film radiographic measurements and novel computed tomography soft tissue measurements.Main Outcome Measure:Acute compartment syndrome (ACS).Results:Schatzker VI fractures (odds ratio 5.72, confidence interval 2.55-12.83, P < 0.001), high-energy mechanism (3.10, 1.26-7.58, P = 0.0096), fibular fracture (8.14, 3.33-19.96, P < 0.0001), fracture length (9.70, 2.45-37.69, P = 0.0014), and plateau-shaft combined injury (2.97, 1.15-7.70, P = 0.019) were all associated with the development of compartment syndrome. The depth of the posterior compartment was also predictive of CS (1.06, 1.02-1.09, P = 0.0025). Patients with 3 and 4 predictive markers demonstrated a 20% and 27% chance of developing ACS respectively.Conclusions:This study confirms that several factors are associated with the development of ACS. The presence of each independent predictor had a cumulative effect such that when more than one variable is present, the chance of ACS increases. This information may be used to alert providers regarding injuries that require vigilant evaluation.Level of Evidence:Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
AB - Objective:To test previously established radiographic predictors of compartment syndrome in tibial plateau fractures and determine whether novel measurements may further improve a surgeon's ability to identity patients at high risk for developing this outcome.Design:Retrospective review.Setting:Academic Level I trauma center.Patients:Five hundred thirteen patients with tibial plateau fractures treated operatively over a 10-year period (OTA/AO 41B1-3 & 41C1-3; Schatzker I-VI).Intervention:Previously established plain film radiographic measurements and novel computed tomography soft tissue measurements.Main Outcome Measure:Acute compartment syndrome (ACS).Results:Schatzker VI fractures (odds ratio 5.72, confidence interval 2.55-12.83, P < 0.001), high-energy mechanism (3.10, 1.26-7.58, P = 0.0096), fibular fracture (8.14, 3.33-19.96, P < 0.0001), fracture length (9.70, 2.45-37.69, P = 0.0014), and plateau-shaft combined injury (2.97, 1.15-7.70, P = 0.019) were all associated with the development of compartment syndrome. The depth of the posterior compartment was also predictive of CS (1.06, 1.02-1.09, P = 0.0025). Patients with 3 and 4 predictive markers demonstrated a 20% and 27% chance of developing ACS respectively.Conclusions:This study confirms that several factors are associated with the development of ACS. The presence of each independent predictor had a cumulative effect such that when more than one variable is present, the chance of ACS increases. This information may be used to alert providers regarding injuries that require vigilant evaluation.Level of Evidence:Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
KW - acute compartment syndrome
KW - fasciotomy
KW - radiographic indicator
KW - tibial plateau fracture
UR - http://www.scopus.com/inward/record.url?scp=85083908838&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85083908838&partnerID=8YFLogxK
U2 - 10.1097/BOT.0000000000001703
DO - 10.1097/BOT.0000000000001703
M3 - Article
C2 - 31738237
AN - SCOPUS:85083908838
SN - 0890-5339
VL - 34
SP - 238
EP - 243
JO - Journal of orthopaedic trauma
JF - Journal of orthopaedic trauma
IS - 5
ER -